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Marina E Eremeeva,
Elsa Berganza,
Gloria Suarez,
Lorena Gobern,
Erica Dueger,
Leticia Castillo,
Lissette Reyes,
Mary E Wikswo,
Kyle F Abramowicz, Gregory A Dasch,
Kim A Lindblade
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ABSTRACT: OBJECTIVES: We describe an outbreak of spotted fever group (SFG) rickettsiosis that occurred in 2007 in a farming community in southeastern Guatemala. We identified 17 cases of an acute febrile illness, among which 10, including two fatalities, were confirmed or probable cases of rickettsial disease (case-fatality proportion 12%). METHODS: PCR, a microimmunofluorescence assay (IFA), and Western blotting were performed on patient samples, and PCR was performed on ticks. RESULTS: Using an indirect IFA, seven of 16 (44%) ill persons tested had both IgM and IgG antibodies reacting with one or more Rickettsia spp antigens; the other nine (56%) had only IgM titers or were seronegative. Antibodies to SFG protein and lipopolysaccharide were detected by Western blotting with antigens of Rickettsia typhi, Rickettsia rickettsii, and Rickettsia akari. Only one sample, from an ill person who died, tested positive by PCR for a SFG Rickettsia. PCR analysis of Amblyomma cajennense ticks from domestic animals in the area detected the presence of SFG Rickettsia DNA in one of 12 ticks collected. CONCLUSIONS: Further studies in Guatemala are warranted to establish the prevalence of rickettsioses and to fully characterize the identity of the etiologic agents and vectors.
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 12/2012; · 2.17 Impact Factor
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Marina E Eremeeva,
Sandor E Karpathy,
Laura Krueger,
Erica K Hayes,
Ashley M Williams,
Yamitzel Zaldivar,
Stephen Bennett,
Robert Cummings,
Art Tilzer,
Robert K Velten,
Nelson Kerr, Gregory A Dasch,
Renjie Hu
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ABSTRACT: Results of an environmental assessment conducted in a newly emergent focus of murine typhus in southern California are described. Opossums, Didelphis virginiana Kerr, infested with cat fleas, Ctenocephalides felis Buché, in the suburban area were abundant. Animal and flea specimens were tested for the DNA of two flea-borne rickettsiae, Rickettsia typhi and Rickettsia felis. R. felis was commonly detected in fleas collected throughout this area while R. typhi was found at a much lower prevalence in the vicinity of just 7 of 14 case-patient homes identified. DNA of R. felis, but not R. typhi, was detected in renal, hepatic, and pulmonary tissues of opossums. In contrast, there were no hematologic polymerase chain reaction findings of R. felis or R. typhi in opossums, rats, and cats within the endemic area studied. Our data suggest a significant probability of human exposure to R. felis in the area studied; however, disease caused by this agent is not recognized by the medical community and may be misdiagnosed as murine typhus using nondiscriminatory serologic methods.
Journal of Medical Entomology 11/2012; 49(6):1485-94. · 1.76 Impact Factor
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Marina E Eremeeva,
Maria L Zambrano,
Luis Anaya,
Lorenza Beati,
Sandor E Karpathy,
Maria Margarida Santos-Silva,
Beatriz Salceda,
Donald MacBeth,
Hector Olguin, Gregory A Dasch,
Celia Alpuche Aranda
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ABSTRACT: Circulation of a unique genetic type of Rickettsia rickettsii in ticks of the Rhipicephalus sanguineus complex was detected in Mexicali, Baja California, Mexico. The Mexican R. rickettsii differed from all isolates previously characterized from the endemic regions of Rocky Mountain spotted fever in northern, central, and southern Americas. Rhipicephalus ticks in Mexicali are genetically different from Rh. sanguineus found in the United States.
Journal of Medical Entomology 03/2011; 48(2):418-21. · 1.76 Impact Factor
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ABSTRACT: A recurrent focus of Rhipicephalus sanguineus infestation was investigated in a suburban area of southern California after reports of suspected Rocky Mountain spotted fever in two dogs on the same property. Abundant quantities of Rh. sanguineus were collected on the property and repeatedly from each dog, and Rickettsia massiliae DNA was detected by polymerase chain reaction (PCR). Whole blood and serum samples from four dogs were tested by using PCR and microimmunofluorescent assay for antibodies against spotted fever group rickettsiae. Serum samples from all four dogs contained antibodies reactive with R. massiliae, R. rhipicephali, R. rickettsii, and 364D Rickettsia but no rickettsial DNA was detected by PCR of blood samples. Serum cross-absorption and Western blot assays implicated R. massiliae as the most likely spotted fever group rickettsiae responsible for seropositivity. To our knowledge, this is the first detection of R. massiliae in ticks in California.
The American journal of tropical medicine and hygiene 02/2011; 84(2):244-9. · 2.59 Impact Factor
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Nanci Silva,
Marina E Eremeeva,
Tatiana Rozental,
Guilherme S Ribeiro,
Christopher D Paddock,
Eduardo Antonio G Ramos,
Alexsandra R M Favacho,
Mitermayer G Reis, Gregory A Dasch,
Elba R S de Lemos,
Albert I Ko
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ABSTRACT: In Brazil, Brazilian spotted fever was once considered the only tick-borne rickettsial disease. We report eschar-associated rickettsial disease that occurred after a tick bite. The etiologic agent is most related to Rickettsia parkeri, R. africae, and R. sibirica and probably widely distributed from Sao Paulo to Bahia in the Atlantic Forest.
Emerging Infectious Diseases 02/2011; 17(2):275-8. · 6.79 Impact Factor
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ABSTRACT: To the Editor: A spay-neuter (sterilization) program for feral cats from Basseterre, the capital of the Caribbean Island St. Kitts, found that most (45/58; 66%) cats had antibodies to spotted fever group rickettsiae (SFGR). The antibodies were detected with Rickettsia rickettsii antigen in a standard microimmunofluorescence assay (1). Titers for 13 (20%) cats were >/=320.
Emerging Infectious Diseases 03/2010; 16(3):570-1. · 6.79 Impact Factor
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Marc R Shapiro,
Curtis L Fritz,
Karen Tait,
Christopher D Paddock,
William L Nicholson,
Kyle F Abramowicz,
Sandor E Karpathy, Gregory A Dasch,
John W Sumner,
Patricia V Adem,
Jamesina J Scott,
Kerry A Padgett,
Sherif R Zaki,
Marina E Eremeeva
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ABSTRACT: Four spotted fever group rickettsiae (SFGR) are known to infect humans in the United States. A member of the SFGR designated 364D and detected in Dermacentor occidentalis ticks has not previously been identified as a human pathogen.
An 80-year-old man from a rural northern California community presented with an eschar on his forearm. A skin punch biopsy of the lesion was evaluated by immunohistochemistry and molecular analysis. Serum specimens obtained from the patient and 3 other area residents with similar illnesses were tested by immunofluorescence and Western immunoblot for antibodies to SFGR. Ticks were collected near the patient's residence and tested for SFGR.
Abundant intracellular rickettsiae and fragmented rickettsial antigens were observed in the mononuclear inflammatory infiltrates of the biopsy. Nucleotide sequences of DNA fragments amplified from the biopsy were identical to those of 364D. Convalescent sera from all four patients exhibited high immunoglobulin G titers to Rickettsia rickettsii, Rickettsia rhipicephali, and 364D antigens. Three adult D. occidentalis were positive for 364D, R. rhipicephali, and an unidentified Rickettsia species.
This is the first confirmation of human disease associated with the SFGR 364D, which was likely transmitted by D. occidentalis. Although the patients described here presented with a single cutaneous eschar as the principal manifestation, the full spectrum of illness associated with 364D has yet to be determined. Possible infection with 364D or other SFGR should be confirmed through molecular techniques in patients who present with "spotless" Rocky Mountain spotted fever or have serum antibodies to R. rickettsii with group-specific assays.
Clinical Infectious Diseases 02/2010; 50(4):541-8. · 9.15 Impact Factor
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ABSTRACT: Several outbreaks of Rocky Mountain spotted fever have occurred in recent years in Colombian communities close to the border with Panama. However, little is known about rickettsiae and rickettsial diseases in eastern Panamanian provinces, the Darien Province and the Kuna Yala, located north of the endemic area in Colombia. In 2007, 289 ticks were collected in several towns from dogs, horses, mules, cows, and pigs. DNA was extracted from 124 Dermacentor nitens, 64 Rhipicephalus sanguineus, 43 Amblyomma ovale, 35 A. cajennense, 10 Boophilus microplus, 4 A. oblongoguttatum, and 9 A. cajennense nymphs. SYBR-Green polymerase chain reaction assays targeting a fragment of the OmpA and 16S rRNA genes were used for detection of DNA of the spotted fever group rickettsiae (SFGR) and Anaplasmataceae (Anaplasma and Ehrlichia), respectively. In total, 37.4% ticks were positive for SFGR, including 20.3% R. sanguineus, 27.9% A. ovale, 25.8% D. nitens, 50% B. microplus, 50% A. oblongoguttatum, and 100% A. cajennense. The presence of Rickettsia amblyommii DNA was confirmed by sequencing in A. cajennense, A. oblongoguttatum, A. ovale, B. microplus, and R. sanguineus. DNA of R. rickettsii was only detected in one D. nitens collected from a horse in Santa Fe, Darien Province. Prevalence of Anaplasmataceae varied from 6.3% in R. sanguineus to 26.5% in A. cajennense. DNA of Ehrlichia chaffensis was found in three D. nitens and three A. cajennense from horses. This is the first study providing molecular characterization and prevalence information on SFGR in ticks from these areas and thus will be helpful for future evaluations of the risk of rickettsial diseases for individuals living in this region.
Journal of Medical Entomology 08/2009; 46(4):856-61. · 1.76 Impact Factor
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Alice S Chapman,
David L Swerdlow,
Virginia M Dato,
Alicia D Anderson,
Claire E Moodie,
Chandra Marriott,
Brian Amman,
Morgan Hennessey,
Perry Fox,
Douglas B Green,
Eric Pegg,
William L Nicholson,
Marina E Eremeeva, Gregory A Dasch
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ABSTRACT: In February 2006, a diagnosis of sylvatic epidemic typhus in a counselor at a wilderness camp in Pennsylvania prompted a retrospective investigation. From January 2004 through January 2006, 3 more cases were identified. All had been counselors at the camp and had experienced febrile illness with myalgia, chills, and sweats; 2 had been hospitalized. All patients had slept in the same cabin and reported having seen and heard flying squirrels inside the wall adjacent to their bed. Serum from each patient had evidence of infection with Rickettsia prowazekii. Analysis of blood and tissue from 14 southern flying squirrels trapped in the woodlands around the cabin indicated that 71% were infected with R. prowazekii. Education and control measures to exclude flying squirrels from housing are essential to reduce the likelihood of sylvatic epidemic typhus.
Emerging Infectious Diseases 08/2009; 15(7):1005-11. · 6.79 Impact Factor
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ABSTRACT: Rocky Mountain spotted fever (RMSF) caused by Rickettsia rickettsii is a severe rickettsiosis that occurs in nearly every state of the continental USA. RMSF is endemic in Central and Southern America, with recent well-documented cases in Mexico, Costa Rica, Panama, Colombia, Brazil, and Argentina. RMSF is the most malignant among known rickettsioses causing severe multiorgan dysfunction and high case fatality rates, which can reach 73% in untreated cases. Variations in pathogenic biotypes of R. rickettsii isolates have been described, and potential correlations of these differences to various clinical manifestations of RMSF have been suggested. We have recently reported on a method of genetic comparison employing sequence differences in intergenic regions (IGR typing) in isolates of R. rickettsii of human, tick, and animal origin. The grouping obtained correlated well with 2 other genotyping systems we have developed, which target the presence and distribution of variable numbers of tandem repeats (TR) and insertion/deletion (INDEL) events. Twenty-five total genotypes of R. rickettsii in 4 primary groups could be distinguished: isolates from Montana, isolates associated with Rhipicephalus sanguineus ticks and human infections in Arizona, other isolates from the USA where Dermacentor variabilis is thought to be the primary vector, and the isolates primarily associated with Amblyomma ticks from Central and South America. In addition, isolate Hlp#2, which is often considered to be a nonpathogenic isolate of R. rickettsii and closely related serotype 364D, exhibited the most diversity from the other isolates compared, and they differ significantly from each other. Because complex interactions underlie the pathogenesis of R. rickettsii in vivo, it is difficult to define the causality of individual events that occur in infected vertebrate hosts and humans. Many microbial factors are likely to contribute to the varied ability of R. rickettsii to cause cellular injury; some of them may also contribute importantly to its virulence for vertebrate hosts and may be linked to the variable genetic markers we have identified. Since circulation of R. rickettsii in nature includes vertical transstadial and transovarial transmission within tick vectors and horizontal passages through vertebrate hosts, it is plausible that isolates of different virulence arose when they became isolated during adaptation to novel vertebrate and tick hosts. Characterization of the physiologically important changes in rickettsial gene expression that occur immediately after tick-to-human or tick-to-animal transitions may require development of new experimental systems.
Annals of the New York Academy of Sciences 06/2009; 1166:12-26. · 3.15 Impact Factor
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ABSTRACT: Dermacentor occidentalis Marx and Dermacentor variabilis (Say) commonly bite humans in California. These Dermacentor species may play a role in transmitting spotted fever group (SFG) rickettsiae to humans in many parts of the state where Dermacentor andersoni Stiles, a known vector for the etiologic agent of Rocky Mountain spotted fever, Rickettsia rickettsii, is absent. However, the specific rickettsial agents present in these ticks and their current prevalence are poorly understood. In total, 365 D. occidentalis and 10 D. variabilis were collected by flagging vegetation at 16 sites in five counties of southern California. The presence of SFG rickettsial DNA in these ticks was detected with rOmpA and GltA gene polymerase chain reaction (PCR) assays. The rickettsial species were identified by sequencing PCR amplicons. Of 365 D. occidentalis, 90 (24.7%) contained R. rhipicephali DNA, 28 (7.7%) contained DNA of unclassified genotype 364D, two (0.55%) contained R. bellii DNA, and one (0.3%) contained R. rickettsii DNA. Of 10 D. variabilis, four (40%) contained only R. rhipicephali. Four new genotypes of R. rhipicephali were discovered. For the first time, we detected R. rickettsii in D. occidentalis. Our study provides the first molecular data on the prevalence and species identification of SFG rickettsiae circulating in populations of these California ticks. Because neither D. variabilis nor R. rickettsii were abundant, 364D should be evaluated further as a potential cause of human SFG rickettsioses in southern California.
Journal of Medical Entomology 06/2008; 45(3):509-16. · 1.76 Impact Factor
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Emerging Infectious Diseases 04/2008; 14(3):511. · 6.79 Impact Factor
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ABSTRACT: Carrion's disease is typically biphasic with acute febrile illness characterized by bacteremia and severe hemolytic anemia (Oroya fever), followed by benign, chronic cutaneous lesions (verruga peruana). The causative agent, Bartonella bacilliformis, is endemic in specific regions of Peru and Ecuador. We describe atypical infection in an expatriate patient who presented with acute splenomegaly and anemia 3 years after visiting Ecuador. Initial serology and PCR of the patient's blood and serum were negative for Bartonella henselae, Bartonella quintana, and B. bacilliformis. Histology of splenic biopsy was suggestive of bacillary angiomatosis, but immunohistochemistry ruled out B. henselae and B. quintana. Bacilli (isolate EC-01) were subsequently cultured from the patient's blood and analyzed using multilocus sequence typing, protein gel electrophoresis with Western blotting, and an immunofluorescence assay (IFA) against a panel of sera from patients with Oroya fever in Peru. The EC-01 nucleotide sequences (gltA and internal transcribed spacer) and protein band banding pattern were most similar to a subset of B. bacilliformis isolates from the region of Caraz, Ancash, in Peru, where B. bacilliformis is endemic. By IFA, the patient's serum reacted strongly to two out of the three Peruvian B. bacilliformis isolates tested, and EC-01 antigen reacted with 13/20 Oroya fever sera. Bacilliary angiomatosis-like lesions were also detected in the spleen of the patient, who was inapparently infected with B. bacilliformis and who presumably acquired infection in a region of Ecuador where B. bacilliformis was not thought to be endemic. This study suggests that the range of B. bacilliformis may be expanding from areas of endemicity in Ecuador and that infection may present as atypical clinical disease.
Journal of clinical microbiology 03/2008; 46(2):627-37. · 4.16 Impact Factor
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ABSTRACT: We describe a fatal pediatric case of Rocky Mountain spotted fever in Panama, the first, to our knowledge, since the 1950s. Diagnosis was established by immunohistochemistry, PCR, and isolation of Rickettsia rickettsii from postmortem tissues. Molecular typing demonstrated strong relatedness of the isolate to strains of R. rickettsii from Central and South America.
Emerging infectious diseases 12/2007; 13(11):1763-5. · 6.17 Impact Factor
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ABSTRACT: Fleas of prairie dogs have been implicated in the transmission of Bartonella spp. We used PCR to test DNA extracts from 47 fleas of prairie dogs from 6 states. We amplified DNA from 5 unique genotypes of Bartonella spp. and 1 Rickettsia sp. from 12 fleas collected in North Dakota, Oklahoma, Texas, and Wyoming. Sequences from the Bartonella spp. were similar, but not identical, to those from prairie dogs and their fleas in Colorado.
Journal of Parasitology 09/2007; 93(4):953-5. · 1.40 Impact Factor
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ABSTRACT: Rickettsia rickettsii, the causative agent of Rocky Mountain spotted fever, is found throughout the Americas, where it is associated with different animal reservoirs and tick vectors. No molecular typing system currently exists to allow for the robust differentiation of isolates of R. rickettsii. Analysis of eight completed genome sequences of rickettsial species revealed a high degree of sequence conservation within the coding regions of chromosomes in the genus. Intergenic regions between coding sequences should be under less selective pressure to maintain this conservation and thus should exhibit greater nucleotide polymorphisms. Utilizing these polymorphisms, we developed a molecular typing system that allows for the genetic differentiation of isolates of R. rickettsii. This typing system was applied to a collection of 38 different isolates collected from humans, animals, and tick vectors from different geographic locations. Serotypes 364D, from Dermacentor occidentalis ticks, and Hlp, from Haemaphysalis leporispalustris ticks, appear to be distinct genotypes that may not belong to the species R. rickettsii. We were also able to differentiate 36 historical isolates of R. rickettsii into three different phylogenetic clades containing seven different genotypes. This differentiation correlated well, but not perfectly, with the geographic origin and likely tick vectors associated with the isolates. The few apparent typing discrepancies found suggest that the molecular ecology of R. rickettsii needs more investigation.
Journal of Clinical Microbiology 09/2007; 45(8):2545-53. · 4.15 Impact Factor
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ABSTRACT: Bartonella spp. are putatively vector-borne bacterial agents of humans and animals. Fleas have been incriminated as vectors of Bartonella spp. and are suspected of transmitting Bartonella of rodents and bats, but some of these Bartonella spp. have not yet been directly detected in wild caught fleas. We report the molecular detection of Bartonella tribocorum, Bartonella vinsonii subsp. vinsonii, and two novel genotypes of Bartonella from the fleas Xenopsylla cheopis, Ctenophthalmus pseudagyrtes, Sternopsylla texanus, or Orchopeas howardi.
Journal of Vector Ecology 07/2007; 32(1):118-22. · 0.88 Impact Factor
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Marina E Eremeeva,
Helen L Gerns,
Shari L Lydy,
Jeanna S Goo,
Edward T Ryan,
Smitha S Mathew,
Mary Jane Ferraro,
Judith M Holden,
William L Nicholson, Gregory A Dasch,
Jane E Koehler
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ABSTRACT: Bartonella species cause serious human infections globally, including bacillary angiomatosis, Oroya fever, trench fever, and endocarditis. We describe a patient who had fever and splenomegaly after traveling to Peru and also had bacteremia from an organism that resembled Bartonella bacilliformis, the causative agent of Oroya fever, which is endemic to Peru. However, genetic analyses revealed that this fastidious bacterium represented a previously uncultured and unnamed bartonella species, closely related to B. clarridgeiae and more distantly related to B. bacilliformis. We characterized this isolate, including its ability to cause fever and sustained bacteremia in a rhesus macaque. The route of infection and burden of human disease associated with this newly described pathogen are currently unknown.
New England Journal of Medicine 07/2007; 356(23):2381-7. · 53.30 Impact Factor
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ABSTRACT: We collected and tested 616 tropical rat mites (Ornithonyssus bacoti (Hirst)) from rats (Rattus norvegicus (Berkenhout) and R. rattus (Linnaeus)) throughout 14 governorates in Egypt and tested DNA extracts from pools of these mites for Bartonella spp., Coxiella burnetii, and Rickettsia spp. by PCR amplification and sequencing. Three different mite-associated bacterial agents, including one Bartonella and two Rickettsia spp., were detected in eight pools of mites. Further research could demonstrate the vector potential of mites and pathogenicity of these agents to humans or animals.
Enperimental and Applied Acarology 02/2007; 41(1-2):101-7. · 1.73 Impact Factor
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Marina E Eremeeva,
Alice Oliveira,
John Moriarity,
Jennilee B Robinson,
Nikolay K Tokarevich,
Ludmila P Antyukova,
Valentina A Pyanyh,
Olga N Emeljanova,
Valentina N Ignatjeva,
Roman Buzinov,
Valentina Pyankova, Gregory A Dasch
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ABSTRACT: Ixodes persulcatus Schultze ticks are traditionally associated with transmission of Lyme disease, babesiosis, and tick-borne encephalitis. Here we compared the prevalence of infection with Borrelia burgdorferi, and rickettsial and ehrlichial agents in I. persulcatus ticks collected in different locations of the North Western administrative region of Russia. Altogether, 27.7% of ticks were infected with at least one organism, while the DNA of two or more bacteria was found in 11.8% of ticks tested. The highest average prevalence of Anaplasmataceae (20.8%) was detected in ticks from Arkhangel'sk province, while the prevalence in ticks from Novgorod province and St. Petersburg, respectively, was 7.3% and 12.2%. Only Ehrlichia muris DNA was identified by DNA sequencing. In comparison, the prevalence of B. burdorferi DNA was 16.6%, 5.8%, and 24.5% in the respective locations. The 382-bp amplicon of gltA from Candidatus Rickettsia tarasevichiae was detected in 2.75% and 1.6%, respectively, of ticks from Arkhangel'sk and Novgorod provinces, extending further west and north the area where this rickettsia is known to be present. DNA of the rickettsia-like endosymbiont Montezuma was primarily associated with female ticks, 8-28% of which were infected. Since I. persulcatus is so commonly infected with multiple agents that may cause human diseases, exposure to these ticks poses significant risk to human health in this region.
Vector Borne and Zoonotic Diseases 02/2007; 7(3):426-36. · 2.44 Impact Factor
